Family Caregiving Experiences of Medical School Faculty: High prevalence, high strain, and low resource awareness

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Skarupski, David L Roth, Samuel C Durso This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4420473/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 12 Nov, 2024 Read the published version in Human Resources for Health → Version 1 posted 9 You are reading this latest preprint version Abstract Background: Adult caregiving can be demanding and stressful, especially when the caregiver is employed. As the age of the U.S. population and workforce increases, more adults are providing care to aging family members. Objective: To understand the prevalence and aspects of caregiving experience and caregiving strain among department of medicine faculty members, and to gauge their awareness and utilization of caregiving resources. Design: We used a cross-sectional survey design. A questionnaire survey was developed and launched in Redcap in October, 2022, and an invitation was emailed followed by two reminders to all full-time and part-time faculty members (N=1,053) in our department of medicine. Adjunct, emeritus and faculty with secondary appointments in the department of medicine were excluded. Main Measures: Faculty demographics, caregiver status, caregiving details, degree of mental or emotional strain, and knowledge of and use of employer and external caregiver resources. Key results: Of the 1,053 faculty members who received up to three email survey invitations, 209 (20%) responded of which 76 (36%) were current caregivers, 16 (8%) were recent caregivers, and 117 (56%) were non-caregivers. Among the 76 current caregivers, 53 (70%) reported providing care for parents or parent-in-laws and 9 (12%) reported caring for a spouse. One third of current and recent caregivers reported care for individuals with Alzheimer’s disease or dementia/memory problems. Over 90% of current or recent caregivers reported some or a lot of caregiving strain. A wide variation in knowledge of and use of employer and external caregiver resources was reported. Conclusions: Department of medicine faculty who provide adult caregiving report a high prevalence of strain and wide variation in knowledge of and use of employer and external caregiver support services, suggesting opportunity to better understand where gaps exist in providing support for caregivers. Academic Medicine Caregiving Workforce Resources Employer-benefits Introduction The average age of full-time medical school faculty members (N = 197,327) in the U.S. is 49.2 years 1 and faculty members age 50 or older comprised 43.3% of the full-time medical school faculty population. 2 Increased age is associated with increased adult caregiving responsibilities. According to a 2017 U.S. Senate special committee on aging report 3 , one out of every four employees over the age of 50 serves as a family caregiver and a 2023 Bureau of Labor Statistics report 4 showed that 61.4% of caregivers during 2021–2022 were employed either full or part-time. Caregiving is often demanding and can be stressful, especially when the caregiver is employed. We tend to associate the term ‘childcare’ when we think about caring for young children and the term ‘caregiving’ when we think about caring for older adults. Both caregiving experiences have similarities and some significant differences. Childcare responsibilities and activities typically: a) result after some amount of planning and preparation, minimally during the nine months’ gestation period; b) occur in a co-residing household with the child/children; and c) include any number of community or employer-provided childcare options (e.g., nannies, au pairs, day care, after-care programs, babysitters, etc.). However, adult caregiving responsibilities and activities may: a) result after an unplanned medical emergency, accident, or other significant life - or death - event; b) occur remotely (cross-nationally or internationally) and require frequent travel and/or relocations; and c) be thwarted by lack of resource awareness in the care recipients’ community and/or inadequate or inaccessible resources. Given these unique challenges that accompany adult caregiving, the experience is oftentimes associated with significant strain and stress. In our 2021 paper 5 , we reported results from a secondary data analysis of a survey of 2,126 full-time medical school faculty age 55 and older (average age 62.3) from 14 U.S. LCME-accredited medical schools, conducted in 2017. We found that 19% of the respondents reported providing care on an on-going basis to a family member, friend, or neighbor with a chronic illness or disability, including 22.4% of the female respondents and 17.3% of the male respondents. Among those who reported caregiving, 90.2% reported experiencing some or a lot of mental or emotional strain from caregiving. In this paper, we report the results from a more extensive survey of caregiving experiences among the faculty members in our department of medicine. Our survey objectives were to understand the caregiving experiences of our institution’s faculty members, including prevalence and aspects of caregiving and caregiver strain, and to gauge their awareness and utilization of caregiving resources. Methods This project utilized a cross-sectional survey design. We developed and launched a questionnaire survey in Redcap in October, 2022. We emailed an invitation and two reminders to all full-time and part-time faculty members (N = 1,053) in our department of medicine. We excluded faculty with only adjunct, emeritus, or secondary appointments (n = 412). In the emailed survey invitation, we described the survey as follows: “The following confidential survey is an important opportunity for you to share your experiences with disability in your family and if that has affected your work as a faculty member in the Johns Hopkins Department of Medicine. The goal of the survey is to better understand the experiences of Johns Hopkins faculty members and their awareness of resources to help families dealing with disabilities. Whether you are providing care for someone with a disability now, or have done so in the past, or have disabilities of your own, or have never had any of these experiences, we would appreciate your participation in our brief survey. It should take you between 5 and 20 minutes to complete the survey, depending on your experiences and responses. Your participation in this on-line survey is purely voluntary, and you may discontinue at any time. The survey responses will be analyzed by statisticians in the Johns Hopkins Center on Aging and Health, and your responses to all questions will be kept completely confidential and will not be disclosed to any of your colleagues or supervisors.” The study was exempted by our institutional review board and categorized as a quality improvement project. In the questionnaire, we asked three primary questions: 1) “Are you currently providing care on an on-going basis to any family member, friend, or neighbor with a chronic illness or disability? This would include any kind of regular help with basic activities such as dressing, bathing, grooming this person, preparing meals, managing bills, arranging for or helping to coordinate medical care, managing medications, watching or supervising this person, or providing transportation.” We also asked, “ Over the past year , have you provided care…” to gauge recent caregiving experiences. Furthermore, we also asked, “Do you have any family members or friends with chronic health conditions or disabilities that you would like to provide help to but don’t have enough time to do so ?; 2) “How much of a mental or emotional strain is it on you to provide this care?”; and 3) “Are you aware of this ( listed ) resource, have you used it in the past, do you use it currently, or do you anticipate using it, and rate your satisfaction.” In the resource lists, we identified caregiving resources available to Hopkins employees, namely: a) Backup Care: reduced fees for in-home care through Care@Work; b) MySupport: up to 5 counseling sessions; c) Lifemart: employees discounts for senior care products; d) dependent care flexible spending accounts; and e) Hopkins-assisted referrals to external agencies such as Area Agencies on Aging and Eldercare Locator). We also included a list of external/community-based caregiving resources, namely: a) respite care such as adult day services; b) home health care/visiting nurses’; c) caregiver-focused counseling services or support groups; d) meal services such as Meals on Wheels; d) transportation services specifically for persons with disabilities; and e) other domestic services for persons with disabilities, such as shopping, cooking, housework, and yardwork. For faculty members who reported caregiving responsibilities, we also inquired about caregiving details, such as: relationship of caregiving recipient (e.g., spouse, mother, father, etc.); number of caregiving recipients; whether the faculty member was/is the primary caregiver; if the caregiving recipient lived/lives with the respondent; age of care recipient; if the care recipient has Alzheimer’s Disease or dementia/memory problems and other major health conditions/disabilities; and if the care recipient needed help with activities of daily living (e.g., dressing, bathing, toileting, etc.) or instrumental activities of daily living (e.g., money, telephone, meal preparation, etc.); and the number of hours per week spent caregiving. Finally, we included standard sociodemographic questions such as age, gender, race, ethnicity, marital status, degree type, full-time or part-time status, number of years at Hopkins, and rank. We tabulated univariate statistics for the total sample (N = 1,053) using SAS Version 9.4. Results Of the 1,053 faculty members who received up to three email survey invitations, 830 (79%) did not respond and of the 223 (21%) respondents, 14 opted-out, which resulted in 209 total survey respondents (20% response rate). Table 1 shows the sociodemographic characteristics of the sample. Of the 209 respondents, 76 (36%) indicated that they were current caregivers, 16 (8%) were recent caregivers, and 117 (56%) were non-caregivers. Among the 117 non-caregivers, 87 (74%) reported that they had no family or friends with disabilities needing their help and 30 (26%) reported that they did have “family members or friends with chronic health conditions or disabilities” whom they did want to provide help for but did not have enough time to do so (i.e., ‘wishful caregivers’). The average age of the respondents was 51.1, 112 (55%) were female, and 144 (69%) were white. Table 1 Faculty survey respondent sociodemographics, by caregiving type TOTAL (N = 209) Current CGs (n = 76 [36%]) Recent CGs (n = 16 [8%]) Non-CGs (n = 117 [56%]) Wishful CGs (n = 30 [14%]) Not Caregiving (no one needs their help) (n = 87 [42%]) Years at Hopkins 15.8 (11.3) 17.9 (10.9) 13.7 (9.5) 15.2 (9.0) 14.4 (12.5) Age mean (SD) range 51.1 (12.0) 30–81 54.0 (11.0) 34–79 48.9 (9.7) 32–65 48.6 (8.9) 35–65 49.7 (13.7) 30–81 Female gender, number (%) Male 112 (54.9) 97 (45.1) 47 (62.7) 29 (37.3) 9 (60.0) 7 (40.0) 18 (64.3) 12 (35.7) 38 (44.2) 49 (55.8) Race African American Asian/Pacific Islander Mixed/Other/Missing White 9 (4.3) 38 (18.2) 18 (8.6) 144 (69.0) 4 (5.3) 15 (19.7) 9 (11.8) 48 (63.2) 1 (6.3) 1 (6.3) 2 (12.5) 12 (75.0) 1 (3.3) 9 (30.0) 1 (3.3) 19 (63.3) 3 (3.5) 13 (14.9) 6 (6.9) 65 (74.7) Non-Hispanic 199 (95.2) 70 (92.1) 15 (93.8) 30 (100.0) 84 (96.6) Marital Status Married Cohabitating Widowed Divorced Separated Single, never married 177 (85.9) 8 (3.9) 3 (1.5) 8 (3.9) 3 (1.5) 7 (3.4) 64 (86.5) 3 (4.1) 1 (1.4) 2 (2.7) 1 (1.4) 3 (4.1) 14 (87.5) -- 1 (6.3) 1 (6.3) -- -- 27 (90.0) 1 (3.3) -- 2 (6.7) -- -- 72 (83.7) 4 (4.7) 1 (1.2) 3 (3.5) 2 (2.3) 4 (4.7) Highest Degree Completed MD PhD or equivalent Masters or equivalent 167 (80.7) 27 (13.0) 13 (6.3) 62 (81.6) 8 (10.5) 6 (7.9) 11 (73.3) 2 (13.3) 2 (13.3) 21 (70.0) 6 (20.0) 3 (10.0) 73 (83.4) 11 (12.8) 2 (2.3) Status Full Time Part Time 175 (83.7) 34 (16.3) 59 (77.6) 17 (22.4) 14 (87.5) 2 (12.5) 28 (93.3) 2 (6.7) 74 (85.1) 13 (14.9) Rank Instructor Research Associate Assistant Prof Associate Prof Professor Professor (PAR) Associate Prof (PAR) 30 (14.4) 10 (4.8) 70 (33.5) 43 (20.6) 54 (25.8) 1 (0.5) 1 (0.5) 10 (13.2) 1 (1.3) 23 (30.3) 18 (23.7) 24 (31.6) -- -- 2 (12.5) -- 7 (43.8) 3 (18.8) 3 (18.8) -- 1 (6.3) 5 (16.7) 4 (13.3) 6 (20.0) 7 (23.3) 8 (26.7) -- -- 13 (14.9) 5 (5.8) 34 (39.1) 15 (17.2) 19 (21.8) 1 (1.2) -- Legend: PAR = pending appointment at rank Table 2 reports caregiving details by current and recent caregivers. Among the 76 current caregivers, 53 (70%) reported providing care for parents or parents-in-law and 9 (12%) reported providing care for a spouse. Among the 16 recent caregivers, 9 (56%) reported providing care for parents or parents-in-law and 3 (19%) reported providing care for a spouse. When the 76 current caregivers were asked, “how much mental or emotional strain is it on you to provide this care?”, 4 (5%) reported no strain, 46 (61%) reported some strain, and 26 (37%) reported a lot of strain. Among the 16 recent caregivers, 2 (13%) reported no strain, 10 (63%) reported some strain, and 4 (25%) reported a lot of strain. Table 2 Caregiving Details, by current and recent caregivers Current CGs (n = 76) Recent CGs (n = 16) Relationship, number (%) Spouse Mother Father Mother-in-law Father-in-law Son Daughter Sister Brother Grandmother Other 9 (12.0) 30 (40.0) 14 (18.7) 6 (8.0) 3 (4.0) 5 (6.7) 1 (1.3) 2 (2.7) 2 (2.7) 2 (2.7) 1 (1.3) 3 (18.8) 4 (25.0) 3 (18.8) 2 (12.5) -- -- 1 (6.3) -- 1 (6.3) 1 (6.3) 1 (6.3) [uncle] How much of a mental or emotional strain is it on you to provide this care? number (%) No strain Some strain A lot of strain 4 (5.3) 46 (60.5) 26 (34.2) 2 (12.5) 10 (62.5) 4 (25.0) Yes, I am/was caregiving for more than one person, number (%) 30 (40.0) 4 (25.0) CG for how many people? mean (SD) range 2.1 (0.5) 1–3 2.5 (1.0) 2–4 Yes, I am the primary CG 41 (54.7) 8 (50.0) CG recipient currently lives with me 22 (30.1) 6 (37.5) Age of care recipient, mean (SD) range 75.7 (19.5) 9-104 68.5 (23.0) 18–90 Recipient has AD or dementia/memory problems, yes 29 (38.2) 2 (12.5) Recipient has other major health conditions/disabilities? Stroke-related impairment/disabilities number (%) Other weakness/physical disability Mental/behav impairments Major sensory impairments Cancer/impairments related to Other 4 (5.3) 36 (47.4) 14 (18.4) 13 (17.1) 12 (15.8) 6 (7.9) 1 (6.3) 7 (43.8) 3 (18.8) -- 2 (12.5) 2 (12.5) Recipient needs help with ADLs? (dressing, bathing, toileting, grooming, eating, in and out of bed) 30 (40.0) 10 (62.5) Recipient needs help with IADLs? (money, telephone, meal prep, meds, shopping, transport) 68 (91.9) 12 (75.0) Hours per week caregiving*, mean (SD) *Men:11.0 (29.7) hrs vs. Women:7.7 (8.4) - ns range 8.8 (18.8) 1-152 11.7 (14.0) 1–44 CG length of time? Years, mean (SD) Months, mean (SD) 5.4 (6.7) 2.6 (3.1) 3.7 (6.6) 2.7 (1.9) Thirty (40%) of the current caregivers and 4 (25%) of the recent caregivers reported that they were caring for more than one person (averages = 2.1 and 2.5, respectively). The top three caregiving relationships among current and recent caregivers were: mother (40% and 25%, respectively); father (19% and 19%); and spouse (12% and 19%, respectively). More than half of current caregivers (55%) and half (50%) of recent caregivers reported that they were the primary caregiver and 30% of current caregivers reported that their care recipient lives with them (38% of recent caregivers reported co-residing). The average age of the current caregivers’ care recipient was 76 (standard deviation = 19.5) and 68.5 (standard deviation = 23.0) for the recent caregivers. More than one-third (38%) of current caregivers reported that their care recipient had AD or dementia/memory problems and 13% of recent caregivers reported the same. The other major health conditions/disabilities for caregivers were: weakness/physical disability; mental/behavior impairments; major sensory impairments; and impairments related to cancer. Forty percent of current caregivers reported that their care recipient needed help with ADLs (63% of recent caregivers) and 92% reported that their recipient needed help with IADLs (75% of recent caregivers). Current caregivers reported an average of 9 hours (sd = 19) per week of caregiving for an average of 5.5 years (sd = 6.7) and recent caregivers reported an average of 12 hours (sd = 14) per week of caregiving for an average of 3.7 years (sd = 6.6). Table 3 reports the awareness and utilization of employer-provided or endorsed caregiving-related resources. Current and recent caregivers’ (n = 92) awareness of the resource ranged from a low of 8% (“Lifemart: employee discounts for senior care products”) to a high of 73% (“Dependent care flexible spending account”). Utilization of these employer-sponsored resources ranged from a low of 17% for backup care to a high of 44% for the dependent care flexible spending account. Satisfaction ratings ranged from a low of 2.0 (Lifemart) to 3.9 (Backup care through Care@Work) on a 1–5 scale, where 1 is very dissatisfied and 5 is very satisfied. Table 3 Hopkins Resources, by Current & Recent Caregivers Combined (n = 92) Yes, I am aware of this resource Yes, I have used this resource Yes, I am currently using this resource Do you anticipate using this resource in the near future? Yes No Not sure If you have used this resource, please rate your satisfaction on a 1–5 scale where 1 is very dissatisfied and 5 is very satisfied. Backup Care: Reduced fees for in-home care through Care@Work 30 (33.0) 5 (16.7) 1 (20.0) 3 (10.0) 13 (43.3) 14 (46.7) 3.9 (0.9) n = 9 MySupport: Up to 5 in-person counseling sessions via telephone 28 (31.5) 8 (28.6) 1 (12.5) 1 (3.6) 15 (53.6) 12 (42.9) 3.2 (1.0) n = 10 Lifemart: Employee discounts for senior care products 7 (7.8) 2 (28.6) -- -- 3 (42.9) 4 (57.1) 2.0 (--) n = 1 Dependent Care Flexible Spending Accounts 64 (72.7) 28 (43.8) 9 (32.1) 12 (18.8) 33 (51.6) 19 (29.7) 3.8 (1.0) n = 43 Hopkins-assisted referrals to external agencies such as Area Agencies on Aging and Eldercare Locator 11 (12.5) 4 (36.4) 1 (25.0) 2 (18.2) 5 (45.5) 4 (36.4) 3.8 (1.9) n = 4 Other (specify): Freq = 1 each for: Care.com; case manager at geriatrics clinic; Healthcare FSA; hired in-home help; Hopkins Home Care; JHHC/Capable (research study) / physicians; local care staffing agencies; PA-based resource; Alz Assn.; place for mom and Aetna (n = 11; 4.2 [1.0]) When presented with the list of external caregiving resources (Table 4 ), nearly half (43%) of the current and recent caregivers (n = 92) indicated that they had utilized home health care/visiting nurses, almost one-quarter (23%) reported having utilized other domestic services for persons with disabilities (e.g., shopping, cooking, housework, yardwork), and the average satisfaction scores were 3.9 and 3.8 respectively, on a 1–5 scale. Table 4 External Resources, by Current & Recent Caregivers Combined (n = 92) Yes, I have used this resource Yes, I am currently using this resource Do you anticipate using this resource in the near future? Yes No Not sure If you have used this resource, please rate your satisfaction on a 1–5 scale where 1 is very dissatisfied and 5 is very satisfied. Respite Care such as Adult Day Services 1 (1.1) 1 (100.) 6 (6.7) 47 (52.8) 36 (40.5) 5.0 (0) n = 2 Home Health Care/Visiting Nurses 39 (43.3) 13 (33.3) 26 (29.2) 27 (30.3) 36 (40.5) 3.9 (1.0) n = 37 Caregiver-focused counseling services or support groups 1 (1.1) -- 8 (9.0) 45 (50.6) 36 (40.5) 4.0 (-) n = 1 Meal Services such as Meals on Wheels 7 (7.8) 3 (42.9) 3 (4.1) 66 (75.0) 19 (21.6) 4.3 (0.5) n = 7 Transportation Services Specifically for Persons with Disabilities 6 (6.7) 4 (66.7) 8 (9.0) 53 (59.6) 28 (31.5) 4.0 (1.0) n = 5 Other Domestic Services (e.g., Shopping, Cooking, Housework, Yardwork) for Persons with Disabilities 21 (23.3) 15 (71.4) 22 (24.7) 34 (38.2) 33 (37.1) 3.8 (1.0) n = 22 Other (Specify): Freq = 1 each for: 24-hour in-home care; hospice (2x); memory care unit in Boston; personal care homes (supervised residential living) and Nursing Homes (SNFs); family, friends, and neighbors; health aide; church community; infusion pharmacy; private duty nurse; self-paid caregivers (n = 10; 4.4 [0.5]) Discussion Through this work, we learned about caregiving experiences among faculty members in a school of medicine. In brief, we report three major findings: 1) a high rate of caregiving; ( 2 ) high caregiving strain among caregivers; 3) general low awareness and utilization of employer-provided/sponsored resources and somewhat higher utilization of external, community-based resources. Globally, longevity is increasing. The World Health Organization (2022) estimates that by 2030, one in six people in the world will be age 60 or older and by 2050, the population of those age 60 or older will double to 2.1 billion 6 . As we age, we inevitably face health challenges that may require some degree of caregiving, such as episodic events requiring short-term hospital or rehabilitation stays or chronic diseases or conditions requiring long-term care, assisted-living, home nurse visits, and/or specialized care treatments for Alzheimer’s/dementia, cancers, renal failure, and other serious chronic conditions. Spouses, partners, and family members are integrally involved in these caregiving life events. In fact, family and unpaid caregivers provide most of the actual care for older adults 7,8 . Furthermore, many of these family caregivers are employed full-time 9 . Additionally, our population’s lower fertility rates have reduced the number of available siblings or family members to assist with caregiving 10 and because academic medicine faculty members are typically a geographically mobile population, their aging parents and relatives may live across the country or around the world, making caregiving an even greater challenge and time-commitment. Indeed, we found a small group of faculty members we called “wishful caregivers” who would have liked to provide help to a family member or friend with a chronic condition or disability, but didn’t have the time to do so. In addition to the general demographic trends, it has been estimated that by 2034, there will be a shortage of between 37,800 and 124,000 physicians 11 ; the primary driver is population growth and aging. This underscores a likely future of increased competition by schools of medicine to recruit and retain their faculty workforce. Increasing age of medical school faculty and the population – in addition to other demographic trends – will inevitably result in increased caregiving demand on faculty time, finances and energy. Ensuring that faculty have the resources to provide for a predictable increase in caregiver demands should become one component of a strategy to maintain well-being and optimize work performance. Our institutional human resource offices posts resources on websites for employees. Unfortunately, many faculty member caregivers report that the website is difficult to find and navigate. Furthermore, when they do find the websites and traverse myriad links, faculty members commonly complain about their experiences. For example, with childcare, faculty members report struggling to identify the appropriate resource(s) and then having trouble securing safe, reliable, and affordable childcare. The experiences of faculty members who are seeking the same safe, reliable, and affordable care for their older loved ones, who oftentimes live geographically distant, can be even more frustrating. Resources to support faculty members who have to and who want to provide care for their parents, parents-in-law, other older family members, spouses, partners should both meet their needs and be non-burdensome to access. In this survey, we did observe that the lowest prevalence of full-time employment (78%) was among current caregivers, which may suggest that caregiving employees may be choosing to or are forced to reduce their employment effort because they have to or want to provide care for their loved one(s). Alternatively, faculty members who are not working full-time may be more likely to take on caregiving responsibilities. Regardless, if employees had accessible and reliable care for their loved ones, they may choose to remain in the workforce longer and/or maintain full-time work status for a longer period of time, which would benefit the institutions. Call for resources, policies, and programs We urge medical schools to assess the caregiving needs of their faculty and identify and vet caregiving resources and support. To improve access to these resources, institutions and/or schools of medicine might invest in new human resource concierge-type positions to help faculty navigate the myriad caregiving policies, programs, and resources. For example, many of our institutions’ libraries have ‘informationists’ (there are 13 informationists at the Johns Hopkins University Welch Medical Library 12 ). Informationists provide information to faculty, staff, and students via their unique skills, expertise, and access to databases and materials not available to the general public. Informationists work with faculty members to clarify the: research question(s) and hypotheses; relevant population/sample; clinical/scientific field and context; span of years; identify other possible related search terms; etc. This service: a) minimizes barriers to research and scholarship by saving faculty members’ precious time; b) contributes to operational and financial efficiencies by appropriately stewarding higher-paid faculty salaries to tasks other than literature searches (i.e., clinical work, other research, education, administrative, and service responsibilities); c) increases faculty confidence in having acquired all the current and relevant literature; and d) increases morale and faculty satisfaction. A caregiving concierge with similar (caregiving) skills, expertise, and access to resources would accomplish the same outcomes for faculty members around national and international home health care providers, adult day services, and care coordination options: a) time saved; b) improved efficiencies; c) increased confidence in knowing all the resources available to them and their loved ones; and d) increased morale and faculty satisfaction, likely resulting in improved retention. Institutions and/or schools of medicine could also reexamine their child-care and elder-care policies for adequate: paid leaves of absence; mini-sabbaticals; temporary part-time employment arrangements; flexible schedules; and tenure-clock freezes. The Family and Medical Leave Act (FMLA) 13 entitles eligible employees to take up to 26 weeks of unpaid , job-protected leave for specified family and medical reasons. In addition to resources and policy changes, institutions could also provide and/or facilitate regular programming for faculty member caregivers. Our school of medicine hosts a monthly ‘virtual caregiving community’ with the goals of: a) sharing caregiving tips, resources, and lessons learned; b) aggregating and sorting information into one document/website for future faculty caregivers; and c) supporting and encouraging each other. Other faculty career development programs include: retirement panel presentations; a three-part ‘Next Chapter” series exploring life after full-time employment; and one-on-one coaching. These and other programs work to normalize the caregiving experience in the work culture. Finally, institutions should systematically collect and monitor data related to: resource utilization and experiences; caregiving status; caregiving strain; anticipated caregiving status for others and for self; intention to retire/exit; and factors associated with retirement/exit. These data could be systematically collected as part of regular faculty satisfaction surveys, faculty well-being, and/or other survey cycles. When data are not measured, false assumptions about faculty members’ wants and needs are more likely. For example, in recent publications, we found that faculty members’ and dean-level leaders’ perceptions about expectations to retire and factors associated with retirement are disparate 14,15 . More systematic data collection and transparent data sharing about such factors are likely to better inform institutional policies and support employee morale. Conclusion Caregiving demands for medical school faculty mirror those of the general population and stress associated with those demands impacts work productivity and satisfaction. Competitive pressure to recruit and retain the best medical school faculty will require understanding the needs of faculty providing or wishing to provide caregiving and then providing adequate and accessible resources that meets those needs. Abbreviations LCME: Liaison Committee on Medical Education; FMLA: Family and Medical Leave Act. Declarations Acknowledgements The authors would like to thank the Johns Hopkins University, School of Medicine, Department of Medicine director, Dr. Nadia Hansel, for facilitating the survey administration and the faculty members in the Department of Medicine. Authors’ contributions Drs. Skarupski, Roth, and Durso collaborated on the study conception and design and the manuscript writing. Drs. Skarupski and Roth developed the data collection tool, and analyzed and interpreted the data. All authors read and approved the final manuscript. Funding None reported. Availability of data and materials The data that support the findings of this study are available from the authors but restrictions apply. Ethical approval and consent to participate The Johns Hopkins Medicine Office of Human Subject Research determined that this quality improvement project did not constitute human subjects research (#IRB00317800). Consent for publication The authors consent for publication. Competing interests The authors have no competing interests Author details 1 Department of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, Maryland References Association of American Medical Colleges. Faculty Roster: U.S. Medical School Faculty. Appendix Table H: Average Age of Full-Time Faculty and Chairs by Gender, Rank, and Department Type, 2023. Available at: https://www.aamc.org/data/facultyroster/. Accessed March 8, 2024. Association of American Medical Colleges. Faculty Roster: U.S. Medical School Faculty. Supplemental Table G. U.S. Medical School Faculty by Race/Ethnicity, Rank, and Age Group, 2023. Available at: https://www.aamc.org/data/facultyroster/. Accessed March 8, 2024. United States Senate. Special Committee on Aging. America’s Aging Workforce: Opportunities & Challenges. (Senator Susan M. Collins, chairman; Senator Robert P. Casey, Jr., ranking member). Available at: r.https://www.aging.senate.gov/imo/media/doc/Aging%20Workforce%20Booklet_4web.pdf. Accessed March 8, 2024. Bureau of Labor Statistics, U. S. Department of Labor. Unpaid eldercare in the United States – 2021-2022. Data from the American time use survey. Table 4. News Release, September 21, 2023. Available at: https://www.bls.gov/news.release/pdf/elcare.pdf. Accessed March 8, 2024. Skarupski KA, Roth DL, Durso SC. Prevalence of caregiving and high caregiving strain among late-career medical school faculty members: Workforce, policy, and faculty development implications. Hum Resour Health. 2021;19:36. https://doi.org/10.1186/s12960-021-00582-3. World Health Organization. Ageing and Health. 1 October 2022. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health. Accessed March 9, 2024. Freedman VA, Spillman BC. Disability and care needs among older Americans. The Milbank Quarterly . 2014;92(3):509-41. Schulz R, Eden J. Families Caring for an Aging America . Washington, DC: The National Academies Press; 2016. Unpaid eldercare in the United States 2013-2014 [Internet]. U.S. Bureau of Labor Statistics. U.S. Bureau of Labor Statistics; 2016 [cited 2021 February 24]. Available from: https://www.bls.gov/news.release/archives/elcare_09232015.htm. Accessed March 9, 2024. Seltzer JA, Bianchi SM. Demographic Change and Parent-Child Relationships in Adulthood. Annu Rev Sociol . 2013;39:275-90. Dall T., Reynolds R, Jones K, Chakrabarti R, Iacobucci W. The Complexities of Physician Supply and Demand: Projections from 2017 to 2032: 2019 Update. Washington, DC: Association of American Medical Colleges. [cited 2021 February 24]. Available from: https://www.aamc.org/data-reports/workforce/data/complexities-physician-supply-and-demand-projections-2019-2034. Accessed March 9, 2024. Welch Medical Library. “Informationists.” Johns Hopkins University. Available from: https://welch.jhmi.edu/about/informationists. Accessed March 9, 2024. U.S. Department of Labor. Family and Medical Leave Act. Available from: https://www.dol.gov/agencies/whd/fmla. Accessed March 9, 2024. Skarupski KA, Welch C, Dandar V, Mylona E, Chatterjee A, Singh M. Late-Career Expectations: A Survey of Full-Time Faculty Members Who Are 55 or Older at 14 U.S. Medical Schools. Academic Medicine . 2019 Jun 18. Skarupski KA, Dandar VA, Mylona EA, Chatterjee AA, Welch CA, Singh MA. Late-Career Faculty: A Survey of Faculty Affairs and Faculty Development Leaders of U.S. Medical Schools. Academic Medicine . 2019 Jun 18. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 12 Nov, 2024 Read the published version in Human Resources for Health → Version 1 posted Editorial decision: Revision requested 14 Jun, 2024 Reviews received at journal 13 Jun, 2024 Reviewers agreed at journal 02 Jun, 2024 Reviews received at journal 29 May, 2024 Reviewers agreed at journal 16 May, 2024 Reviewers invited by journal 15 May, 2024 Submission checks completed at journal 15 May, 2024 Editor assigned by journal 15 May, 2024 First submitted to journal 14 May, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4420473","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":304645718,"identity":"dd5dbffa-aee3-40f9-a365-d39ad224861a","order_by":0,"name":"Kimberly A. Skarupski","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3ElEQVRIiWNgGAWjYBACCQY2KIOZ+YAxiM/AkEC0FrYEUrUw8BgwQ5gEtEj2H0v8XNl2x16ynedDcWGOBQM/e44BXi3SEmmHJc+2PUuczcy7wXjmNgkGyZ43+LXISbA3SDa2HU6QA2nhBWoxuEHAFjn+480/gVrs5Zh5HoC12BPSIs2QdgxkC+NsZh4GiC0SBLRIzkhLs2w49yxxZjObAUgLj8SZZwV4tUicP2Z8s6Hsjr3E+cPPgFrq5Pjbkzfg1QIFB0AEG8hBPMQoh2thfkCs8lEwCkbBKBhZAADxLkAHSH4wNAAAAABJRU5ErkJggg==","orcid":"","institution":"Johns Hopkins University","correspondingAuthor":true,"prefix":"","firstName":"Kimberly","middleName":"A.","lastName":"Skarupski","suffix":""},{"id":304645719,"identity":"a198dc57-d2b0-4faa-b22e-442724371076","order_by":1,"name":"David L Roth","email":"","orcid":"","institution":"Johns Hopkins University","correspondingAuthor":false,"prefix":"","firstName":"David","middleName":"L","lastName":"Roth","suffix":""},{"id":304645720,"identity":"635ebf2c-9700-4cac-8f74-b51bcdda81ea","order_by":2,"name":"Samuel C Durso","email":"","orcid":"","institution":"Johns Hopkins University","correspondingAuthor":false,"prefix":"","firstName":"Samuel","middleName":"C","lastName":"Durso","suffix":""}],"badges":[],"createdAt":"2024-05-14 16:00:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4420473/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4420473/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12960-024-00944-7","type":"published","date":"2024-11-12T15:57:29+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":69275004,"identity":"bde4e049-f7e7-4fd2-ad37-512f2402fcc6","added_by":"auto","created_at":"2024-11-18 16:44:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":732685,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4420473/v1/76618de5-87c4-42c5-90f9-c361957c4896.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Family Caregiving Experiences of Medical School Faculty: High prevalence, high strain, and low resource awareness","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe average age of full-time medical school faculty members (N\u0026thinsp;=\u0026thinsp;197,327) in the U.S. is 49.2 years\u003csup\u003e1\u003c/sup\u003e and faculty members age 50 or older comprised 43.3% of the full-time medical school faculty population.\u003csup\u003e2\u003c/sup\u003e Increased age is associated with increased adult caregiving responsibilities. According to a 2017 U.S. Senate special committee on aging report\u003csup\u003e3\u003c/sup\u003e, one out of every four employees over the age of 50 serves as a family caregiver and a 2023 Bureau of Labor Statistics report\u003csup\u003e4\u003c/sup\u003e showed that 61.4% of caregivers during 2021\u0026ndash;2022 were employed either full or part-time. Caregiving is often demanding and can be stressful, especially when the caregiver is employed.\u003c/p\u003e \u003cp\u003eWe tend to associate the term \u0026lsquo;childcare\u0026rsquo; when we think about caring for young children and the term \u0026lsquo;caregiving\u0026rsquo; when we think about caring for older adults. Both caregiving experiences have similarities and some significant differences. Childcare responsibilities and activities typically: a) result after some amount of planning and preparation, minimally during the nine months\u0026rsquo; gestation period; b) occur in a co-residing household with the child/children; and c) include any number of community or employer-provided childcare options (e.g., nannies, au pairs, day care, after-care programs, babysitters, etc.). However, adult caregiving responsibilities and activities may: a) result after an unplanned medical emergency, accident, or other significant life - or death - event; b) occur remotely (cross-nationally or internationally) and require frequent travel and/or relocations; and c) be thwarted by lack of resource awareness in the care recipients\u0026rsquo; community and/or inadequate or inaccessible resources. Given these unique challenges that accompany adult caregiving, the experience is oftentimes associated with significant strain and stress.\u003c/p\u003e \u003cp\u003eIn our 2021 paper\u003csup\u003e5\u003c/sup\u003e, we reported results from a secondary data analysis of a survey of 2,126 full-time medical school faculty age 55 and older (average age 62.3) from 14 U.S. LCME-accredited medical schools, conducted in 2017. We found that 19% of the respondents reported providing care on an on-going basis to a family member, friend, or neighbor with a chronic illness or disability, including 22.4% of the female respondents and 17.3% of the male respondents. Among those who reported caregiving, 90.2% reported experiencing some or a lot of mental or emotional strain from caregiving.\u003c/p\u003e \u003cp\u003eIn this paper, we report the results from a more extensive survey of caregiving experiences among the faculty members in our department of medicine. Our survey objectives were to understand the caregiving experiences of our institution\u0026rsquo;s faculty members, including prevalence and aspects of caregiving and caregiver strain, and to gauge their awareness and utilization of caregiving resources.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis project utilized a cross-sectional survey design. We developed and launched a questionnaire survey in Redcap in October, 2022. We emailed an invitation and two reminders to all full-time and part-time faculty members (N\u0026thinsp;=\u0026thinsp;1,053) in our department of medicine. We excluded faculty with only adjunct, emeritus, or secondary appointments (n\u0026thinsp;=\u0026thinsp;412).\u003c/p\u003e \u003cp\u003eIn the emailed survey invitation, we described the survey as follows: \u0026ldquo;The following confidential survey is an important opportunity for you to share your experiences with disability in your family and if that has affected your work as a faculty member in the Johns Hopkins Department of Medicine. The goal of the survey is to better understand the experiences of Johns Hopkins faculty members and their awareness of resources to help families dealing with disabilities. Whether you are providing care for someone with a disability now, or have done so in the past, or have disabilities of your own, or have never had any of these experiences, we would appreciate your participation in our brief survey. It should take you between 5 and 20 minutes to complete the survey, depending on your experiences and responses. Your participation in this on-line survey is purely voluntary, and you may discontinue at any time. The survey responses will be analyzed by statisticians in the Johns Hopkins Center on Aging and Health, and your responses to all questions will be kept completely confidential and will not be disclosed to any of your colleagues or supervisors.\u0026rdquo; The study was exempted by our institutional review board and categorized as a quality improvement project.\u003c/p\u003e \u003cp\u003eIn the questionnaire, we asked three primary questions: 1) \u0026ldquo;Are you \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003ecurrently\u003c/span\u003e providing care on an on-going basis to any family member, friend, or neighbor with a chronic illness or disability? This would include any kind of regular help with basic activities such as dressing, bathing, grooming this person, preparing meals, managing bills, arranging for or helping to coordinate medical care, managing medications, watching or supervising this person, or providing transportation.\u0026rdquo; We also asked, \u0026ldquo;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eOver the past year\u003c/span\u003e, have you provided care\u0026hellip;\u0026rdquo; to gauge recent caregiving experiences. Furthermore, we also asked, \u0026ldquo;Do you have any family members or friends with chronic health conditions or disabilities that \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eyou would like to provide help to but don\u0026rsquo;t have enough time to do so\u003c/span\u003e?; 2) \u0026ldquo;How much of a \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003emental or emotional strain\u003c/span\u003e is it on you to provide this care?\u0026rdquo;; and 3) \u0026ldquo;Are you aware of this (\u003cem\u003elisted\u003c/em\u003e) resource, have you used it in the past, do you use it currently, or do you anticipate using it, and rate your satisfaction.\u0026rdquo;\u003c/p\u003e \u003cp\u003e In the resource lists, we identified caregiving resources available to Hopkins employees, namely: a) Backup Care: reduced fees for in-home care through Care@Work; b) MySupport: up to 5 counseling sessions; c) Lifemart: employees discounts for senior care products; d) dependent care flexible spending accounts; and e) Hopkins-assisted referrals to external agencies such as Area Agencies on Aging and Eldercare Locator). We also included a list of external/community-based caregiving resources, namely: a) respite care such as adult day services; b) home health care/visiting nurses\u0026rsquo;; c) caregiver-focused counseling services or support groups; d) meal services such as Meals on Wheels; d) transportation services specifically for persons with disabilities; and e) other domestic services for persons with disabilities, such as shopping, cooking, housework, and yardwork.\u003c/p\u003e \u003cp\u003eFor faculty members who reported caregiving responsibilities, we also inquired about caregiving details, such as: relationship of caregiving recipient (e.g., spouse, mother, father, etc.); number of caregiving recipients; whether the faculty member was/is the primary caregiver; if the caregiving recipient lived/lives with the respondent; age of care recipient; if the care recipient has Alzheimer\u0026rsquo;s Disease or dementia/memory problems and other major health conditions/disabilities; and if the care recipient needed help with activities of daily living (e.g., dressing, bathing, toileting, etc.) or instrumental activities of daily living (e.g., money, telephone, meal preparation, etc.); and the number of hours per week spent caregiving.\u003c/p\u003e \u003cp\u003eFinally, we included standard sociodemographic questions such as age, gender, race, ethnicity, marital status, degree type, full-time or part-time status, number of years at Hopkins, and rank.\u003c/p\u003e \u003cp\u003eWe tabulated univariate statistics for the total sample (N\u0026thinsp;=\u0026thinsp;1,053) using SAS Version 9.4.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOf the 1,053 faculty members who received up to three email survey invitations, 830 (79%) did not respond and of the 223 (21%) respondents, 14 opted-out, which resulted in 209 total survey respondents (20% response rate). Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the sociodemographic characteristics of the sample. Of the 209 respondents, 76 (36%) indicated that they were current caregivers, 16 (8%) were recent caregivers, and 117 (56%) were non-caregivers. Among the 117 non-caregivers, 87 (74%) reported that they had no family or friends with disabilities needing their help and 30 (26%) reported that they did have \u0026ldquo;family members or friends with chronic health conditions or disabilities\u0026rdquo; whom they did want to provide help for but did not have enough time to do so (i.e., \u0026lsquo;wishful caregivers\u0026rsquo;). The average age of the respondents was 51.1, 112 (55%) were female, and 144 (69%) were white.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFaculty survey respondent sociodemographics, by caregiving type\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTOTAL\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;209)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCurrent CGs\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;76 [36%])\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRecent CGs\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;16 [8%])\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eNon-CGs (n\u0026thinsp;=\u0026thinsp;117 [56%])\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eWishful CGs\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;30 [14%])\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot Caregiving (no one needs their help)\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;87 [42%])\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYears at Hopkins\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.8 (11.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.9 (10.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.7 (9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15.2 (9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14.4 (12.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge \u003cem\u003emean (SD)\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003erange\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51.1 (12.0)\u003c/p\u003e \u003cp\u003e30\u0026ndash;81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54.0 (11.0)\u003c/p\u003e \u003cp\u003e34\u0026ndash;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48.9 (9.7)\u003c/p\u003e \u003cp\u003e32\u0026ndash;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e48.6 (8.9)\u003c/p\u003e \u003cp\u003e35\u0026ndash;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e49.7 (13.7)\u003c/p\u003e \u003cp\u003e30\u0026ndash;81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale gender, \u003cem\u003enumber (%)\u003c/em\u003e\u003c/p\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112 (54.9)\u003c/p\u003e \u003cp\u003e97 (45.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47 (62.7)\u003c/p\u003e \u003cp\u003e29 (37.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (60.0)\u003c/p\u003e \u003cp\u003e7 (40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e18 (64.3)\u003c/p\u003e \u003cp\u003e12 (35.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e38 (44.2)\u003c/p\u003e \u003cp\u003e49 (55.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRace\u003c/p\u003e \u003cp\u003eAfrican American\u003c/p\u003e \u003cp\u003eAsian/Pacific Islander\u003c/p\u003e \u003cp\u003eMixed/Other/Missing\u003c/p\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (4.3)\u003c/p\u003e \u003cp\u003e38 (18.2)\u003c/p\u003e \u003cp\u003e18 (8.6)\u003c/p\u003e \u003cp\u003e144 (69.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (5.3)\u003c/p\u003e \u003cp\u003e15 (19.7)\u003c/p\u003e \u003cp\u003e9 (11.8)\u003c/p\u003e \u003cp\u003e48 (63.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003cp\u003e2 (12.5)\u003c/p\u003e \u003cp\u003e12 (75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (3.3)\u003c/p\u003e \u003cp\u003e9 (30.0)\u003c/p\u003e \u003cp\u003e1 (3.3)\u003c/p\u003e \u003cp\u003e19 (63.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (3.5)\u003c/p\u003e \u003cp\u003e13 (14.9)\u003c/p\u003e \u003cp\u003e6 (6.9)\u003c/p\u003e \u003cp\u003e65 (74.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-Hispanic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e199 (95.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70 (92.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15 (93.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e84 (96.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital Status\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003eCohabitating\u003c/p\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003cp\u003eSeparated\u003c/p\u003e \u003cp\u003eSingle, never married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e177 (85.9)\u003c/p\u003e \u003cp\u003e8 (3.9)\u003c/p\u003e \u003cp\u003e3 (1.5)\u003c/p\u003e \u003cp\u003e8 (3.9)\u003c/p\u003e \u003cp\u003e3 (1.5)\u003c/p\u003e \u003cp\u003e7 (3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64 (86.5)\u003c/p\u003e \u003cp\u003e3 (4.1)\u003c/p\u003e \u003cp\u003e1 (1.4)\u003c/p\u003e \u003cp\u003e2 (2.7)\u003c/p\u003e \u003cp\u003e1 (1.4)\u003c/p\u003e \u003cp\u003e3 (4.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (87.5)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27 (90.0)\u003c/p\u003e \u003cp\u003e1 (3.3)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e2 (6.7)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e72 (83.7)\u003c/p\u003e \u003cp\u003e4 (4.7)\u003c/p\u003e \u003cp\u003e1 (1.2)\u003c/p\u003e \u003cp\u003e3 (3.5)\u003c/p\u003e \u003cp\u003e2 (2.3)\u003c/p\u003e \u003cp\u003e4 (4.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHighest Degree Completed\u003c/p\u003e \u003cp\u003eMD\u003c/p\u003e \u003cp\u003ePhD or equivalent\u003c/p\u003e \u003cp\u003eMasters or equivalent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e167 (80.7)\u003c/p\u003e \u003cp\u003e27 (13.0)\u003c/p\u003e \u003cp\u003e13 (6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62 (81.6)\u003c/p\u003e \u003cp\u003e8 (10.5)\u003c/p\u003e \u003cp\u003e6 (7.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (73.3)\u003c/p\u003e \u003cp\u003e2 (13.3)\u003c/p\u003e \u003cp\u003e2 (13.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21 (70.0)\u003c/p\u003e \u003cp\u003e6 (20.0)\u003c/p\u003e \u003cp\u003e3 (10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e73 (83.4)\u003c/p\u003e \u003cp\u003e11 (12.8)\u003c/p\u003e \u003cp\u003e2 (2.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStatus\u003c/p\u003e \u003cp\u003eFull Time\u003c/p\u003e \u003cp\u003ePart Time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e175 (83.7)\u003c/p\u003e \u003cp\u003e34 (16.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59 (77.6)\u003c/p\u003e \u003cp\u003e17 (22.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (87.5)\u003c/p\u003e \u003cp\u003e2 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28 (93.3)\u003c/p\u003e \u003cp\u003e2 (6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e74 (85.1)\u003c/p\u003e \u003cp\u003e13 (14.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRank\u003c/p\u003e \u003cp\u003eInstructor\u003c/p\u003e \u003cp\u003eResearch Associate\u003c/p\u003e \u003cp\u003eAssistant Prof\u003c/p\u003e \u003cp\u003eAssociate Prof\u003c/p\u003e \u003cp\u003eProfessor\u003c/p\u003e \u003cp\u003eProfessor (PAR)\u003c/p\u003e \u003cp\u003eAssociate Prof (PAR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (14.4)\u003c/p\u003e \u003cp\u003e10 (4.8)\u003c/p\u003e \u003cp\u003e70 (33.5)\u003c/p\u003e \u003cp\u003e43 (20.6)\u003c/p\u003e \u003cp\u003e54 (25.8)\u003c/p\u003e \u003cp\u003e1 (0.5)\u003c/p\u003e \u003cp\u003e1 (0.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (13.2)\u003c/p\u003e \u003cp\u003e1 (1.3)\u003c/p\u003e \u003cp\u003e23 (30.3)\u003c/p\u003e \u003cp\u003e18 (23.7)\u003c/p\u003e \u003cp\u003e24 (31.6)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (12.5)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e7 (43.8)\u003c/p\u003e \u003cp\u003e3 (18.8)\u003c/p\u003e \u003cp\u003e3 (18.8)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (16.7)\u003c/p\u003e \u003cp\u003e4 (13.3)\u003c/p\u003e \u003cp\u003e6 (20.0)\u003c/p\u003e \u003cp\u003e7 (23.3)\u003c/p\u003e \u003cp\u003e8 (26.7)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 (14.9)\u003c/p\u003e \u003cp\u003e5 (5.8)\u003c/p\u003e \u003cp\u003e34 (39.1)\u003c/p\u003e \u003cp\u003e15 (17.2)\u003c/p\u003e \u003cp\u003e19 (21.8)\u003c/p\u003e \u003cp\u003e1 (1.2)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eLegend: PAR\u0026thinsp;=\u0026thinsp;pending appointment at rank\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e reports caregiving details by current and recent caregivers. Among the 76 current caregivers, 53 (70%) reported providing care for parents or parents-in-law and 9 (12%) reported providing care for a spouse. Among the 16 recent caregivers, 9 (56%) reported providing care for parents or parents-in-law and 3 (19%) reported providing care for a spouse. When the 76 current caregivers were asked, \u0026ldquo;how much mental or emotional strain is it on you to provide this care?\u0026rdquo;, 4 (5%) reported no strain, 46 (61%) reported some strain, and 26 (37%) reported a lot of strain. Among the 16 recent caregivers, 2 (13%) reported no strain, 10 (63%) reported some strain, and 4 (25%) reported a lot of strain.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCaregiving Details, by current and recent caregivers\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCurrent CGs (n\u0026thinsp;=\u0026thinsp;76)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRecent CGs (n\u0026thinsp;=\u0026thinsp;16)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship, \u003cem\u003enumber (%)\u003c/em\u003e\u003c/p\u003e \u003cp\u003eSpouse\u003c/p\u003e \u003cp\u003eMother\u003c/p\u003e \u003cp\u003eFather\u003c/p\u003e \u003cp\u003eMother-in-law\u003c/p\u003e \u003cp\u003eFather-in-law\u003c/p\u003e \u003cp\u003eSon\u003c/p\u003e \u003cp\u003eDaughter\u003c/p\u003e \u003cp\u003eSister\u003c/p\u003e \u003cp\u003eBrother\u003c/p\u003e \u003cp\u003eGrandmother\u003c/p\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (12.0)\u003c/p\u003e \u003cp\u003e30 (40.0)\u003c/p\u003e \u003cp\u003e14 (18.7)\u003c/p\u003e \u003cp\u003e6 (8.0)\u003c/p\u003e \u003cp\u003e3 (4.0)\u003c/p\u003e \u003cp\u003e5 (6.7)\u003c/p\u003e \u003cp\u003e1 (1.3)\u003c/p\u003e \u003cp\u003e2 (2.7)\u003c/p\u003e \u003cp\u003e2 (2.7)\u003c/p\u003e \u003cp\u003e2 (2.7)\u003c/p\u003e \u003cp\u003e1 (1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (18.8)\u003c/p\u003e \u003cp\u003e4 (25.0)\u003c/p\u003e \u003cp\u003e3 (18.8)\u003c/p\u003e \u003cp\u003e2 (12.5)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003cp\u003e1 (6.3) [uncle]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow much of a mental or emotional strain is it on you to provide this care? \u003cem\u003enumber (%)\u003c/em\u003e\u003c/p\u003e \u003cp\u003eNo strain\u003c/p\u003e \u003cp\u003eSome strain\u003c/p\u003e \u003cp\u003eA lot of strain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (5.3)\u003c/p\u003e \u003cp\u003e46 (60.5)\u003c/p\u003e \u003cp\u003e26 (34.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (12.5)\u003c/p\u003e \u003cp\u003e10 (62.5)\u003c/p\u003e \u003cp\u003e4 (25.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes, I am/was caregiving for more than one person, \u003cem\u003enumber (%)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30 (40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (25.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCG for how many people? \u003cem\u003emean (SD)\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003erange\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.1 (0.5)\u003c/p\u003e \u003cp\u003e1\u0026ndash;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.5 (1.0)\u003c/p\u003e \u003cp\u003e2\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes, I am the primary CG\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e41 (54.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (50.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCG recipient currently lives with me\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (30.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (37.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge of care recipient, \u003cem\u003emean (SD)\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003erange\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e75.7 (19.5)\u003c/p\u003e \u003cp\u003e9-104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68.5 (23.0)\u003c/p\u003e \u003cp\u003e18\u0026ndash;90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecipient has AD or dementia/memory problems, \u003cem\u003eyes\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29 (38.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (12.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecipient has other major health conditions/disabilities?\u003c/p\u003e \u003cp\u003eStroke-related impairment/disabilities \u003cem\u003enumber (%)\u003c/em\u003e\u003c/p\u003e \u003cp\u003eOther weakness/physical disability\u003c/p\u003e \u003cp\u003eMental/behav impairments\u003c/p\u003e \u003cp\u003eMajor sensory impairments\u003c/p\u003e \u003cp\u003eCancer/impairments related to\u003c/p\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (5.3)\u003c/p\u003e \u003cp\u003e36 (47.4)\u003c/p\u003e \u003cp\u003e14 (18.4)\u003c/p\u003e \u003cp\u003e13 (17.1)\u003c/p\u003e \u003cp\u003e12 (15.8)\u003c/p\u003e \u003cp\u003e6 (7.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003cp\u003e7 (43.8)\u003c/p\u003e \u003cp\u003e3 (18.8)\u003c/p\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e2 (12.5)\u003c/p\u003e \u003cp\u003e2 (12.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecipient needs help with ADLs? (dressing, bathing, toileting, grooming, eating, in and out of bed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30 (40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (62.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecipient needs help with IADLs? (money, telephone, meal prep, meds, shopping, transport)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68 (91.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (75.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHours per week caregiving*, \u003cem\u003emean (SD)\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003e*Men:11.0 (29.7) hrs vs. Women:7.7 (8.4) - ns range\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.8 (18.8)\u003c/p\u003e \u003cp\u003e1-152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.7 (14.0)\u003c/p\u003e \u003cp\u003e1\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCG length of time? Years, \u003cem\u003emean (SD)\u003c/em\u003e\u003c/p\u003e \u003cp\u003eMonths, \u003cem\u003emean (SD)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.4 (6.7)\u003c/p\u003e \u003cp\u003e2.6 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.7 (6.6)\u003c/p\u003e \u003cp\u003e2.7 (1.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e Thirty (40%) of the current caregivers and 4 (25%) of the recent caregivers reported that they were caring for more than one person (averages\u0026thinsp;=\u0026thinsp;2.1 and 2.5, respectively). The top three caregiving relationships among current and recent caregivers were: mother (40% and 25%, respectively); father (19% and 19%); and spouse (12% and 19%, respectively). More than half of current caregivers (55%) and half (50%) of recent caregivers reported that they were the primary caregiver and 30% of current caregivers reported that their care recipient lives with them (38% of recent caregivers reported co-residing). The average age of the current caregivers\u0026rsquo; care recipient was 76 (standard deviation\u0026thinsp;=\u0026thinsp;19.5) and 68.5 (standard deviation\u0026thinsp;=\u0026thinsp;23.0) for the recent caregivers.\u003c/p\u003e \u003cp\u003eMore than one-third (38%) of current caregivers reported that their care recipient had AD or dementia/memory problems and 13% of recent caregivers reported the same. The other major health conditions/disabilities for caregivers were: weakness/physical disability; mental/behavior impairments; major sensory impairments; and impairments related to cancer. Forty percent of current caregivers reported that their care recipient needed help with ADLs (63% of recent caregivers) and 92% reported that their recipient needed help with IADLs (75% of recent caregivers). Current caregivers reported an average of 9 hours (sd\u0026thinsp;=\u0026thinsp;19) per week of caregiving for an average of 5.5 years (sd\u0026thinsp;=\u0026thinsp;6.7) and recent caregivers reported an average of 12 hours (sd\u0026thinsp;=\u0026thinsp;14) per week of caregiving for an average of 3.7 years (sd\u0026thinsp;=\u0026thinsp;6.6).\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e reports the awareness and utilization of employer-provided or endorsed caregiving-related resources. Current and recent caregivers\u0026rsquo; (n\u0026thinsp;=\u0026thinsp;92) awareness of the resource ranged from a low of 8% (\u0026ldquo;Lifemart: employee discounts for senior care products\u0026rdquo;) to a high of 73% (\u0026ldquo;Dependent care flexible spending account\u0026rdquo;). Utilization of these employer-sponsored resources ranged from a low of 17% for backup care to a high of 44% for the dependent care flexible spending account. Satisfaction ratings ranged from a low of 2.0 (Lifemart) to 3.9 (Backup care through Care@Work) on a 1\u0026ndash;5 scale, where 1 is very dissatisfied and 5 is very satisfied.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHopkins Resources, by Current \u0026amp; Recent Caregivers Combined (n\u0026thinsp;=\u0026thinsp;92)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, I am aware of this resource\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes, I have used this resource\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes, I am currently using this resource\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDo you anticipate using this resource in the near future?\u003c/p\u003e \u003cp\u003e\u003cem\u003eYes\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003eNo\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003eNot sure\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eIf you have used this resource, please rate your satisfaction on a 1\u0026ndash;5 scale where 1 is very dissatisfied and 5 is very satisfied.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBackup Care: Reduced fees for in-home care through Care@Work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (33.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (10.0)\u003c/p\u003e \u003cp\u003e13 (43.3)\u003c/p\u003e \u003cp\u003e14 (46.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.9 (0.9)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMySupport: Up to 5 in-person counseling sessions via telephone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (31.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (28.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (3.6)\u003c/p\u003e \u003cp\u003e15 (53.6)\u003c/p\u003e \u003cp\u003e12 (42.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.2 (1.0)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLifemart: Employee discounts for senior care products\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (28.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e--\u003c/p\u003e \u003cp\u003e3 (42.9)\u003c/p\u003e \u003cp\u003e4 (57.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.0 (--)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDependent Care Flexible Spending Accounts\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64 (72.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (43.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (32.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 (18.8)\u003c/p\u003e \u003cp\u003e33 (51.6)\u003c/p\u003e \u003cp\u003e19 (29.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.8 (1.0)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHopkins-assisted referrals to external agencies such as Area Agencies on Aging and Eldercare Locator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (36.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (18.2)\u003c/p\u003e \u003cp\u003e5 (45.5)\u003c/p\u003e \u003cp\u003e4 (36.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.8 (1.9)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eOther (specify): Freq\u0026thinsp;=\u0026thinsp;1 each for: Care.com; case manager at geriatrics clinic; Healthcare FSA; hired in-home help; Hopkins Home Care; JHHC/Capable (research study) / physicians; local care staffing agencies; PA-based resource; Alz Assn.; place for mom and Aetna (n\u0026thinsp;=\u0026thinsp;11; 4.2 [1.0])\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhen presented with the list of external caregiving resources (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e), nearly half (43%) of the current and recent caregivers (n\u0026thinsp;=\u0026thinsp;92) indicated that they had utilized home health care/visiting nurses, almost one-quarter (23%) reported having utilized other domestic services for persons with disabilities (e.g., shopping, cooking, housework, yardwork), and the average satisfaction scores were 3.9 and 3.8 respectively, on a 1\u0026ndash;5 scale.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eExternal Resources, by Current \u0026amp; Recent Caregivers Combined (n\u0026thinsp;=\u0026thinsp;92)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes, I have used this resource\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes, I am currently using this resource\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDo you anticipate using this resource in the near future?\u003c/p\u003e \u003cp\u003e\u003cem\u003eYes\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003eNo\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003eNot sure\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIf you have used this resource, please rate your satisfaction on a 1\u0026ndash;5 scale where 1 is very dissatisfied and 5 is very satisfied.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespite Care such as Adult Day Services\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (100.)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (6.7)\u003c/p\u003e \u003cp\u003e47 (52.8)\u003c/p\u003e \u003cp\u003e36 (40.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.0 (0)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHome Health Care/Visiting Nurses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39 (43.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26 (29.2)\u003c/p\u003e \u003cp\u003e27 (30.3)\u003c/p\u003e \u003cp\u003e36 (40.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.9 (1.0)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver-focused counseling services or support groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (9.0)\u003c/p\u003e \u003cp\u003e45 (50.6)\u003c/p\u003e \u003cp\u003e36 (40.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.0 (-)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeal Services such as Meals on Wheels\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (42.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (4.1)\u003c/p\u003e \u003cp\u003e66 (75.0)\u003c/p\u003e \u003cp\u003e19 (21.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.3 (0.5)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTransportation Services Specifically for Persons with Disabilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (9.0)\u003c/p\u003e \u003cp\u003e53 (59.6)\u003c/p\u003e \u003cp\u003e28 (31.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.0 (1.0)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther Domestic Services (e.g., Shopping, Cooking, Housework, Yardwork) for Persons with Disabilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (23.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (71.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22 (24.7)\u003c/p\u003e \u003cp\u003e34 (38.2)\u003c/p\u003e \u003cp\u003e33 (37.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.8 (1.0)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eOther (Specify): Freq\u0026thinsp;=\u0026thinsp;1 each for: 24-hour in-home care; hospice (2x); memory care unit in Boston; personal care homes (supervised residential living) and Nursing Homes (SNFs); family, friends, and neighbors; health aide; church community; infusion pharmacy; private duty nurse; self-paid caregivers (n\u0026thinsp;=\u0026thinsp;10; 4.4 [0.5])\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThrough this work, we learned about caregiving experiences among faculty members in a school of medicine. In brief, we report three major findings: 1) a high rate of caregiving; (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) high caregiving strain among caregivers; 3) general low awareness and utilization of employer-provided/sponsored resources and somewhat higher utilization of external, community-based resources.\u003c/p\u003e \u003cp\u003eGlobally, longevity is increasing. The World Health Organization (2022) estimates that by 2030, one in six people in the world will be age 60 or older and by 2050, the population of those age 60 or older will double to 2.1 billion\u003csup\u003e6\u003c/sup\u003e. As we age, we inevitably face health challenges that may require some degree of caregiving, such as episodic events requiring short-term hospital or rehabilitation stays or chronic diseases or conditions requiring long-term care, assisted-living, home nurse visits, and/or specialized care treatments for Alzheimer\u0026rsquo;s/dementia, cancers, renal failure, and other serious chronic conditions. Spouses, partners, and family members are integrally involved in these caregiving life events. In fact, family and unpaid caregivers provide most of the actual care for older adults\u003csup\u003e7,8\u003c/sup\u003e. Furthermore, many of these family caregivers are employed full-time\u003csup\u003e9\u003c/sup\u003e. Additionally, our population\u0026rsquo;s lower fertility rates have reduced the number of available siblings or family members to assist with caregiving\u003csup\u003e10\u003c/sup\u003e and because academic medicine faculty members are typically a geographically mobile population, their aging parents and relatives may live across the country or around the world, making caregiving an even greater challenge and time-commitment. Indeed, we found a small group of faculty members we called \u0026ldquo;wishful caregivers\u0026rdquo; who would have liked to provide help to a family member or friend with a chronic condition or disability, but didn\u0026rsquo;t have the time to do so.\u003c/p\u003e \u003cp\u003eIn addition to the general demographic trends, it has been estimated that by 2034, there will be a shortage of between 37,800 and 124,000 physicians\u003csup\u003e11\u003c/sup\u003e; the primary driver is population growth and aging. This underscores a likely future of increased competition by schools of medicine to recruit and retain their faculty workforce. Increasing age of medical school faculty and the population \u0026ndash; in addition to other demographic trends \u0026ndash; will inevitably result in increased caregiving demand on faculty time, finances and energy. Ensuring that faculty have the resources to provide for a predictable increase in caregiver demands should become one component of a strategy to maintain well-being and optimize work performance.\u003c/p\u003e \u003cp\u003eOur institutional human resource offices posts resources on websites for employees. Unfortunately, many faculty member caregivers report that the website is difficult to find and navigate. Furthermore, when they do find the websites and traverse myriad links, faculty members commonly complain about their experiences. For example, with childcare, faculty members report struggling to identify the appropriate resource(s) and then having trouble securing safe, reliable, and affordable childcare. The experiences of faculty members who are seeking the same safe, reliable, and affordable care for their older loved ones, who oftentimes live geographically distant, can be even more frustrating. Resources to support faculty members who have to and who want to provide care for their parents, parents-in-law, other older family members, spouses, partners should both meet their needs and be non-burdensome to access. In this survey, we did observe that the lowest prevalence of full-time employment (78%) was among current caregivers, which may suggest that caregiving employees may be choosing to or are forced to reduce their employment effort because they \u003cem\u003ehave to\u003c/em\u003e or \u003cem\u003ewant to\u003c/em\u003e provide care for their loved one(s). Alternatively, faculty members who are not working full-time may be more likely to take on caregiving responsibilities. Regardless, if employees had accessible and reliable care for their loved ones, they may choose to remain in the workforce longer and/or maintain full-time work status for a longer period of time, which would benefit the institutions.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eCall for resources, policies, and programs\u003c/h2\u003e \u003cp\u003eWe urge medical schools to assess the caregiving needs of their faculty and identify and vet caregiving resources and support. To improve access to these resources, institutions and/or schools of medicine might invest in new human resource concierge-type positions to help faculty navigate the myriad caregiving policies, programs, and resources. For example, many of our institutions\u0026rsquo; libraries have \u0026lsquo;informationists\u0026rsquo; (there are 13 informationists at the Johns Hopkins University Welch Medical Library\u003csup\u003e12\u003c/sup\u003e). Informationists provide information to faculty, staff, and students via their unique skills, expertise, and access to databases and materials not available to the general public. Informationists work with faculty members to clarify the: research question(s) and hypotheses; relevant population/sample; clinical/scientific field and context; span of years; identify other possible related search terms; etc. This service: a) minimizes barriers to research and scholarship by saving faculty members\u0026rsquo; precious time; b) contributes to operational and financial efficiencies by appropriately stewarding higher-paid faculty salaries to tasks other than literature searches (i.e., clinical work, other research, education, administrative, and service responsibilities); c) increases faculty confidence in having acquired all the current and relevant literature; and d) increases morale and faculty satisfaction. A caregiving concierge with similar (caregiving) skills, expertise, and access to resources would accomplish the same outcomes for faculty members around national and international home health care providers, adult day services, and care coordination options: a) time saved; b) improved efficiencies; c) increased confidence in knowing all the resources available to them and their loved ones; and d) increased morale and faculty satisfaction, likely resulting in improved retention.\u003c/p\u003e \u003cp\u003eInstitutions and/or schools of medicine could also reexamine their child-care and elder-care policies for adequate: paid leaves of absence; mini-sabbaticals; temporary part-time employment arrangements; flexible schedules; and tenure-clock freezes. The Family and Medical Leave Act (FMLA)\u003csup\u003e13\u003c/sup\u003e entitles eligible employees to take up to 26 weeks of \u003cem\u003eunpaid\u003c/em\u003e, job-protected leave for specified family and medical reasons.\u003c/p\u003e \u003cp\u003eIn addition to resources and policy changes, institutions could also provide and/or facilitate regular programming for faculty member caregivers. Our school of medicine hosts a monthly \u0026lsquo;virtual caregiving community\u0026rsquo; with the goals of: a) sharing caregiving tips, resources, and lessons learned; b) aggregating and sorting information into one document/website for future faculty caregivers; and c) supporting and encouraging each other. Other faculty career development programs include: retirement panel presentations; a three-part \u0026lsquo;Next Chapter\u0026rdquo; series exploring life after full-time employment; and one-on-one coaching. These and other programs work to normalize the caregiving experience in the work culture.\u003c/p\u003e \u003cp\u003eFinally, institutions should systematically collect and monitor data related to: resource utilization and experiences; caregiving status; caregiving strain; anticipated caregiving status for others and for self; intention to retire/exit; and factors associated with retirement/exit. These data could be systematically collected as part of regular faculty satisfaction surveys, faculty well-being, and/or other survey cycles. When data are not measured, false assumptions about faculty members\u0026rsquo; wants and needs are more likely. For example, in recent publications, we found that faculty members\u0026rsquo; and dean-level leaders\u0026rsquo; perceptions about expectations to retire and factors associated with retirement are disparate\u003csup\u003e14,15\u003c/sup\u003e. More systematic data collection and transparent data sharing about such factors are likely to better inform institutional policies and support employee morale.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eCaregiving demands for medical school faculty mirror those of the general population and stress associated with those demands impacts work productivity and satisfaction. Competitive pressure to recruit and retain the best medical school faculty will require understanding the needs of faculty providing or wishing to provide caregiving and then providing adequate and accessible resources that meets those needs.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eLCME: Liaison Committee on Medical Education; FMLA: Family and Medical Leave Act.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the Johns Hopkins University, School of Medicine, Department of Medicine director, Dr. Nadia Hansel, for facilitating the survey administration and the faculty members in the Department of Medicine.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026rsquo; contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDrs. Skarupski, Roth, and Durso collaborated on the study conception and design and the manuscript writing. Drs. Skarupski and Roth developed the data collection tool, and analyzed and interpreted the data. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone reported.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from the authors but restrictions apply.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Johns Hopkins Medicine Office of Human Subject Research determined that this quality improvement project did not constitute human subjects research (#IRB00317800).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors consent for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u0026nbsp;\u003c/sup\u003eDepartment of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, Maryland\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAssociation of American Medical Colleges. Faculty Roster: U.S. Medical School Faculty. Appendix Table H: Average Age of Full-Time Faculty and Chairs by Gender, Rank, and Department Type, 2023. Available at: https://www.aamc.org/data/facultyroster/. Accessed March 8, 2024.\u003c/li\u003e\n\u003cli\u003eAssociation of American Medical Colleges. Faculty Roster: U.S. Medical School Faculty. Supplemental Table G. U.S. Medical School Faculty by Race/Ethnicity, Rank, and Age Group, 2023. Available at: https://www.aamc.org/data/facultyroster/. Accessed March 8, 2024.\u003c/li\u003e\n\u003cli\u003eUnited States Senate. Special Committee on Aging. America\u0026rsquo;s Aging Workforce: Opportunities \u0026amp; Challenges. (Senator Susan M. Collins, chairman; Senator Robert P. Casey, Jr., ranking member). Available at: r.https://www.aging.senate.gov/imo/media/doc/Aging%20Workforce%20Booklet_4web.pdf. Accessed March 8, 2024.\u003c/li\u003e\n\u003cli\u003eBureau of Labor Statistics, U. S. Department of Labor. Unpaid eldercare in the United States \u0026ndash; 2021-2022. Data from the American time use survey. Table 4. News Release, September 21, 2023. Available at: https://www.bls.gov/news.release/pdf/elcare.pdf. Accessed March 8, 2024.\u003c/li\u003e\n\u003cli\u003eSkarupski KA, Roth DL, Durso SC. Prevalence of caregiving and high caregiving strain among late-career medical school faculty members: Workforce, policy, and faculty development implications. Hum Resour Health. 2021;19:36. https://doi.org/10.1186/s12960-021-00582-3. \u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Ageing and Health. 1 October 2022. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health. Accessed March 9, 2024.\u003c/li\u003e\n\u003cli\u003eFreedman VA, Spillman BC. Disability and care needs among older Americans. \u003cem\u003eThe\u003c/em\u003e\u003cem\u003eMilbank Quarterly\u003c/em\u003e. 2014;92(3):509-41.\u003c/li\u003e\n\u003cli\u003eSchulz R, Eden J. \u003cem\u003eFamilies Caring for an Aging America\u003c/em\u003e. Washington, DC: The National Academies Press; 2016.\u003c/li\u003e\n\u003cli\u003eUnpaid eldercare in the United States 2013-2014 [Internet]. U.S. Bureau of Labor Statistics. U.S. Bureau of Labor Statistics; 2016 [cited 2021 February 24]. Available from: https://www.bls.gov/news.release/archives/elcare_09232015.htm. Accessed March 9, 2024.\u003c/li\u003e\n\u003cli\u003eSeltzer JA, Bianchi SM. Demographic Change and Parent-Child Relationships in Adulthood. \u003cem\u003eAnnu Rev Sociol\u003c/em\u003e. 2013;39:275-90.\u003c/li\u003e\n\u003cli\u003eDall T., Reynolds R, Jones K, Chakrabarti R, Iacobucci W. The Complexities of Physician Supply and Demand: Projections from 2017 to 2032: 2019 Update. Washington, DC: Association of American Medical Colleges. [cited 2021 February 24]. Available from: https://www.aamc.org/data-reports/workforce/data/complexities-physician-supply-and-demand-projections-2019-2034. Accessed March 9, 2024.\u003c/li\u003e\n\u003cli\u003eWelch Medical Library. \u0026ldquo;Informationists.\u0026rdquo; Johns Hopkins University. Available from: https://welch.jhmi.edu/about/informationists. Accessed March 9, 2024.\u003c/li\u003e\n\u003cli\u003eU.S. Department of Labor. Family and Medical Leave Act. Available from: https://www.dol.gov/agencies/whd/fmla. Accessed March 9, 2024.\u003c/li\u003e\n\u003cli\u003eSkarupski KA, Welch C, Dandar V, Mylona E, Chatterjee A, Singh M. Late-Career Expectations: A Survey of Full-Time Faculty Members Who Are 55 or Older at 14 U.S. Medical Schools. \u003cem\u003eAcademic Medicine\u003c/em\u003e. 2019 Jun 18.\u003c/li\u003e\n\u003cli\u003eSkarupski KA, Dandar VA, Mylona EA, Chatterjee AA, Welch CA, Singh MA. Late-Career Faculty: A Survey of Faculty Affairs and Faculty Development Leaders of U.S. Medical Schools. \u003cem\u003eAcademic Medicine\u003c/em\u003e. 2019 Jun 18.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"human-resources-for-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"hrhe","sideBox":"Learn more about [Human Resources for Health](http://human-resources-health.biomedcentral.com)","snPcode":"12960","submissionUrl":"https://submission.nature.com/new-submission/12960/3","title":"Human Resources for Health","twitterHandle":"@HRH_Journal","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Academic Medicine, Caregiving, Workforce, Resources, Employer-benefits","lastPublishedDoi":"10.21203/rs.3.rs-4420473/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4420473/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eAdult caregiving can be demanding and stressful, especially when the caregiver is employed. As the age of the U.S. population and workforce increases, more adults are providing care to aging family members.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective: \u003c/strong\u003eTo understand the prevalence and aspects of caregiving experience and caregiving strain among department of medicine faculty members, and to gauge their awareness and utilization of caregiving resources.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDesign:\u003c/strong\u003e We used a cross-sectional survey design. A questionnaire survey was developed and launched in Redcap in October, 2022, and an invitation was emailed followed by two reminders to all full-time and part-time faculty members (N=1,053) in our department of medicine. Adjunct, emeritus and faculty with secondary appointments in the department of medicine were excluded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMain Measures: \u003c/strong\u003eFaculty demographics, caregiver status, caregiving details, degree of mental or emotional strain, and knowledge of and use of employer and external caregiver resources.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKey results:\u003c/strong\u003e Of the 1,053 faculty members who received up to three email survey invitations, 209 (20%) responded of which 76 (36%) were current caregivers, 16 (8%) were recent caregivers, and 117 (56%) were non-caregivers. Among the 76 current caregivers, 53 (70%) reported providing care for parents or parent-in-laws and 9 (12%) reported caring for a spouse. One third of current and recent caregivers reported care for individuals with Alzheimer’s disease or dementia/memory problems. Over 90% of current or recent caregivers reported some or a lot of caregiving strain. A wide variation in knowledge of and use of employer and external caregiver resources was reported.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e Department of medicine faculty who provide adult caregiving report a high prevalence of strain and wide variation in knowledge of and use of employer and external caregiver support services, suggesting opportunity to better understand where gaps exist in providing support for caregivers.\u003c/p\u003e","manuscriptTitle":"Family Caregiving Experiences of Medical School Faculty: High prevalence, high strain, and low resource awareness","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-23 12:23:22","doi":"10.21203/rs.3.rs-4420473/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-06-14T18:18:37+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-06-13T13:05:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"289754483922778244321010647089737323941","date":"2024-06-03T00:22:01+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-05-29T20:01:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"209227813352589907870111509547883454274","date":"2024-05-16T13:04:38+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-05-15T16:05:05+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-05-15T06:15:03+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-15T06:15:03+00:00","index":"","fulltext":""},{"type":"submitted","content":"Human Resources for Health","date":"2024-05-14T15:59:06+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"human-resources-for-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"hrhe","sideBox":"Learn more about [Human Resources for Health](http://human-resources-health.biomedcentral.com)","snPcode":"12960","submissionUrl":"https://submission.nature.com/new-submission/12960/3","title":"Human Resources for Health","twitterHandle":"@HRH_Journal","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"45e71137-87cf-4fce-b15c-01618016e55e","owner":[],"postedDate":"May 23rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-11-18T16:02:06+00:00","versionOfRecord":{"articleIdentity":"rs-4420473","link":"https://doi.org/10.1186/s12960-024-00944-7","journal":{"identity":"human-resources-for-health","isVorOnly":false,"title":"Human Resources for Health"},"publishedOn":"2024-11-12 15:57:29","publishedOnDateReadable":"November 12th, 2024"},"versionCreatedAt":"2024-05-23 12:23:22","video":"","vorDoi":"10.1186/s12960-024-00944-7","vorDoiUrl":"https://doi.org/10.1186/s12960-024-00944-7","workflowStages":[]},"version":"v1","identity":"rs-4420473","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4420473","identity":"rs-4420473","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}